Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A.
Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A.
Arthroscopy. 2014 Apr;30(4):436-43. doi: 10.1016/j.arthro.2013.12.013. Epub 2014 Feb 20.
The purpose of this study was to investigate current trends in arthroscopic and open shoulder stabilization in the United States.
Patients who underwent arthroscopic shoulder stabilization (Current Procedural Terminology code 29806) or open stabilization (Current Procedural Terminology codes 23455 [open Bankart repair], 23460 [anterior bone block], and 23462 [coracoid transfer]) were identified using a national database of insurance billing records during the years 2004 through 2009. Demographic data were recorded for each patient.
From 2004 through 2009, there were 23,096 cases of shoulder stabilization, of which 84% (19,337) were arthroscopic and 16% (3,759) were open procedures. There were 17,241 male patients (75%) and 5,855 female patients (25%). The incidence of arthroscopic shoulder stabilization nearly doubled during the period studied, increasing from 11.8 cases for every 10,000 patients in 2004 to 22.9 cases for every 10,000 patients in 2009. The percentage of arthroscopic stabilizations increased from 71% of stabilization procedures in 2004 to 89% in 2009, whereas the percentage of open stabilizations decreased from 29% in 2004 to 11% in 2009 (P < .0001). Among open procedures, a significant decline in the incidence of open Bankart repair was observed, from 4.5 cases for every 10,000 patients in 2004 to 2.2 cases for every 10,000 patients in 2009 (P < .0001), whereas the performance of open coracoid transfer increased from 0.17 cases per 10,000 patients in 2004 to 0.40 cases per 10,000 patients in 2009 (P < .0001). For both arthroscopic and open stabilization, the group aged 10 to 19 years had the highest rate of surgery (29%), followed by the group aged 20 to 29 years (25%).
The current data indicate that arthroscopic stabilization is performed in nearly 90% of shoulder stabilization surgeries and nearly doubled in incidence from 2004 to 2009 in the United States. Additional research is needed to further investigate the long-term clinical outcomes of this practice pattern.
Level IV, retrospective database review.
本研究旨在调查美国关节镜和开放性肩部稳定术的当前趋势。
使用医疗保险计费记录的国家数据库，在 2004 年至 2009 年期间，确定接受关节镜下肩部稳定术（当前程序术语代码 29806）或开放性稳定术（当前程序术语代码 23455 [开放性 Bankart 修复术]、23460 [前骨块]和 23462 [喙突转移]）的患者。记录每位患者的人口统计学数据。
2004 年至 2009 年期间，有 23096 例肩部稳定术，其中 84%（19337 例）为关节镜下手术，16%（3759 例）为开放性手术。17241 名男性患者（75%）和 5855 名女性患者（25%）。在研究期间，关节镜下肩部稳定术的发生率几乎翻了一番，从 2004 年的每 10000 例患者 11.8 例增加到 2009 年的每 10000 例患者 22.9 例。关节镜稳定术的比例从 2004 年的稳定术的 71%增加到 2009 年的 89%，而开放性稳定术的比例从 2004 年的 29%下降到 2009 年的 11%（P<.0001）。在开放性手术中，开放性 Bankart 修复术的发生率显著下降，从 2004 年的每 10000 例患者 4.5 例降至 2009 年的每 10000 例患者 2.2 例（P<.0001），而开放性喙突转移的比例从 2004 年的每 10000 例患者 0.17 例增加到 2009 年的每 10000 例患者 0.40 例（P<.0001）。对于关节镜和开放性稳定术，年龄在 10 至 19 岁的患者手术率最高（29%），其次是 20 至 29 岁的患者（25%）。
目前的数据表明，在美国，近 90%的肩部稳定术采用关节镜稳定术，2004 年至 2009 年间，其发病率几乎翻了一番。需要进一步研究以进一步调查这种实践模式的长期临床结果。
IV 级，回顾性数据库研究。
